HomeMy WebLinkAbout0020749-Building
PERMIT - APPLICAT-ION AND RECORD
CITY OF OS
Owner
PLUMBING CONTRACTOR
Bu. San. Sewer - Curb to Bu.
Bu. St. Sewer Curb to Bu.
L./
Main to Curb:
Main to Curb
Sewer Fees
Water Service
Bath Tub Floor Drain Urinal
Wash Basin ~ Garbage Disp. - S. Sink
Water Closet - Dish Washer - Catch Basin
Kit. Sink Laundry Mach. - S. Pump -
Water Heater - Water Soft. B & S Waste -
Shower Bath - Bubbier Conductors
Plumbing F",,~ Total Fees
HEATING CONTRACTOR~
,
Fuel: Gas D Oil D Elec. D Solar D Solid D
Conditioning Forced Air D HW. D Elec. Base D Steam D Radiant D
System High Elf. D Supplementary D Air Condo D Ventilation D
Chimney: "A" D "B" D Direct Vent D Con. Burner D Flue Damper & E.!. D
Calculated Heat Loss System BTU Rating
ELECTRIC CONTRACTOR
Electric Service: New
Description-Type
Fixtures-
Appliances
Changes
Temp.
Switches
Volts
Recep's
Amps
Circ's
Electrical Signs
N~
20749
Fence
- Id. No.
~ Flood Plain~
?Þ' /Permit Date I ~ {S- -'5"('"
L
Height:
Stories and Basement
Width 01 Lol
íßé>~\
.\JoU¡
,_~z.'«-~II.
t
r I ('
/0 It- C'6
Architect
Inspections -
Footing
Eiectric Service
Foundation
R.!.
Sewer
Estimated codf ~:y») t ¡,.') 1.../ Fees Paid ¡ ¿ ø< /' Date '7 -I !;;-fif-
TO THE BUILDIN NSPECTOR: In accordance with Section 7-18 olthe Municipal Code of the City 01 Oshkosh, It IS agreed that ,Iwork shall be
discontinued for a period of 30 days at any lime for any cause after excavation work is commenced, a solid barrier, wall, orwire fence not less than
live feet in height shall be, erected all around such excavation. Suc~w.all or wire lencewil!¡emai'lln position until removal is approved by the
Building Inspector.
Owner
Address
Phone
..2 ,,?/-/7',:::,-;k;
By
Agent
(Acthml,,' Slg""M"
Address
Phone
S"" of WI"onsln
O,pa"m,nt of Indu"ry,
Labor & Human R"atlons
Division of Safety & Buildings
Box 7969
Madison, W' 53707
WisconsinS",u"s tOt.G3, 10t.73
WISCONSIN UNIFORM
BUILDING PERMIT
APPLICA TION
(See Instruction on back)
"7
~
Basemen" I:;¿/o
Living Area Q(o~4
Garage ï(¿,[!;) Sq. ft.
APPLICATION NO,
c7¥i
PARCEL NO.
"ÔFcul,lB---
Telephone ./ L
;;¿if,/ /1'. {sZ3 [d$F-
Telephone /l, ~fI ¿;"
ò277 r.!ri:-! ¡;'!'"
,T~ì.N,R, l7 E-
Lot No.
P,.., O~
Left
ft. 'Z:z..4<¡:,-/
Fuel
LP Gas
Nat. Gas
Fuel Oil
Electric
Wood
Solar
Coal
Othe,
Block No.
Right
ft. I>:::J ft.
S ace Ht. Wate, Ht .
[J 0
Ji:t ~
[J 0
[J 0
[] 0
D 0
D D
~@I"
t4'!!'1
$ (",OOÙ
The applicent ag,ees to comply with the Wisconsin Uniform Dwelling Code and other Muncipal Ordinances and with the conditions of this permit; understands
that the issuance of the permit creates no legal liability, exp'ess or implied, on the Department or Municipality; and ce,tifies that all the above information is
SIG~ATURE OF APPLICANT DATE ~7
CONDITIONS OF APPROV A
This pe,mit is issued pursuant to he following conditions. Failu,e to comply may 'esult in suspension or ,"voca.
tion of this permit or othe, penalty.
OVILLAGE
Ost-i- kDSl+-
OTOWN
Plan Review. . $
Inspection. . . $
Wis. Permit Seal Is) . . . $
Othe,. . . . . $
TOTAL..... .$
DILHR-SBD 5823 (R-I/82)
NAME
DATE
OOthe,
?;>z 8 7;;;
CERT. NO.
GREEN - Inso"'o'
PINK - Own,,/Ag,nt
&0
WHITE
Issuing Ju';sdiction
VELLOW- OILHR
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